Pediatric Health Library

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Henoch-Schönlein Purpura (HSP) in Children

What is Henoch-Schönlein purpura in children?

Henoch-Schönlein purpura (HSP) is a condition that involves swelling (inflammation) of
small blood vessels. The swollen blood vessels leak into the skin, joints, intestines,
and kidneys. HSP is seen most often in children between ages 2 and 6. It occurs more
often in boys. The disease can happen in siblings of the same family. Most children with
HSP recover fully. But some children may have kidney problems.

What causes Henoch-Schönlein purpura in a child?

HSP is an autoimmune disorder. This is when the body’s immune system attacks the body’s own cells and organs. With HSP, this immune response may be caused by an upper respiratory tract infection. Other immune triggers may include an allergic reaction, medicine, injury, or being out in cold weather.

What are the symptoms of Henoch-Schönlein purpura in a child?

Each child’s symptoms can vary. Common symptoms include:

A rash caused by blood leaking into the skin

Blood leaking into mucous membranes, internal organs, and other tissues

Joint pain and swelling (arthritis)

Belly (abdominal) pain

Bleeding in the digestive tract, which includes the mouth, esophagus, stomach, and
intestines

Swollen kidneys

Swelling just below the skin

A brain disorder

Inflammation of the testicles

These symptoms can seem like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is Henoch-Schönlein purpura diagnosed in a child?

Your
child’s healthcare provider will ask about your child’s health history and do a physical
exam. Diagnosis is based on symptoms such as:

Joint pain and swelling (arthritis)

A rash

Belly pain

Kidney disease

Your
child may also need tests, such as:

Biopsy.
Small tissue samples may be taken. They may be taken from the skin or the kidney.
They are looked at with a microscope. This may only be needed if the diagnosis is
unclear.

Blood and urine tests. Your child's urine will be checked for blood and protein. A blood test can check kidney function.

Ultrasound. This imaging test uses sound waves and a computer to make
pictures of blood vessels, tissues, and organs. It may be used to look at the
digestive tract for signs of the disease.

How is Henoch-Schönlein purpura treated in a child?

Treatment will depend on your child’s symptoms, age, and general
health. It will also depend on how severe the condition is.

Treatments for HSP may include:

Making
sure your child drinks enough fluids

Making
sure your child eats a healthy diet

Taking
medicines such as acetaminophen to help ease pain

Taking
glucocorticoids to control inflammation

Taking
blood pressure medicine to lower blood pressure if needed

Natural
supplements such as fish oil and antioxidants may help

Talk
with your child’s healthcare provider about the risks, benefits, and possible side
effects of all medicines.

What are the complications of Henoch-Schönlein purpura in a child?

Most
children with HSP recover fully. But some children may have kidney damage. In rare
cases, a child may have kidney failure. Women who have had HSP as a child have a higher
risk for pregnancy-induced hypertension (pre-eclampsia).

When should I call my child’s healthcare provider?

Tell the healthcare provider if your child’s symptoms get worse or there are new symptoms.

Key points about Henoch-Schönlein purpura in children

Henoch-Schönlein purpura (HSP) is a condition that involves swelling (inflammation) of small blood vessels.

The swollen blood vessels leak into the skin, joints, intestines, and kidneys.

It is seen most often in children between the ages of 2 and 6. It occurs more often in boys.

HSP is an autoimmune disease that is often triggered by an upper respiratory infection.

Symptoms include a rash caused by bleeding under the skin, arthritis, belly pain, and kidney disease.

Most children recover fully. But some children may have kidney problems.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

Know the reason for the visit and what you want to happen.

Before your visit, write down questions you want answered.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

Ask if your child’s condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if your child does not take the medicine or have the test or procedure.

If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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